Search

Asako Tanaka, Masayuki Hata, Memiri Tsuchikawa, Naoko Ueda-Arakawa Ueda-Arakawa, Hiroshi Tamura, Manabu Miyata, Ayako Takahashi, Ai Kido, Yuki Muraoka, Masahiro Miyake, Sotaro Ooto, Akitaka Tsujikawa Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanCorrespondence: Masayuki Hata, Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan, Tel +81-75-751-3248, Fax +81-75-752-0933, Email trj74h6@kuhp.kyoto-u.ac.jpPurpose: To evaluate the efficacy and safety of faricimab injections for treatment-naïve neovascular age-related macular degeneration (nvAMD) patients, including subtypes and pachychoroid phenotypes, and identify predictive factors for visual outcomes.Methods: nvAMD patients were prospectively recruited, receiving three monthly faricimab (6 mg) injections. Best-corrected visual acuity (BCVA) two months after the last injection (month 4) was compared between subtypes, and between pachychoroid neovasculopathy (PNV) and non-PNV eyes. Regression analysis determined factors influencing month 4 BCVA.Results: The study involved 23 patients (12 typical AMD [tAMD], 10 polypoidal choroidal vasculopathy [PCV], 1 retinal angiomatous proliferation [RAP]). Eleven exhibited PNV phenotype. Significant BCVA (P = 4.9 × 10− 4) and central retinal thickness (CRT) (P = 1.3 × 10− 5) improvements were observed post-faricimab treatment. The therapy demonstrated favourable results for both tAMD and PCV eyes, and non-PNV and PNV eyes. Faricimab achieved dry macula in 77.3% of eyes, with subretinal fluid resolution in most cases, although intraretinal fluid (IRF) often persisted. Multivariable analysis identified external limiting membrane (ELM) presence and IRF as BCVA contributors at month 4.Conclusion: Faricimab demonstrated significant effectiveness and safety in treatment-naïve nvAMD patients, particularly for PCV and PNV eyes. ELM presence and IRF is predictive of visual outcomes.Keywords: anti-VEGF, anti-vascular endothelial growth factor, CRT, central retinal thickness, ELM, external limiting membrane, faricimab, IRF, intraretinal fluid, MNV, macular neovascularization, nvAMD, neovascular age-related macular degeneration, PCV, polypoidal choroidal vasculopathy, PNV, pachychoroid neovasculopathy, RAP, retinal angiomatous proliferation

GaN grown via oxide vapor phase epitaxy (OVPE-GaN) can produce free-standing substrates with ultra-low resistivity because of the high doping concentration of oxygen. The bulk growth of OVPE-GaN is hindered by polycrystals generated during long-term growth. We have previously reported that thicker films can be grown by reducing the partial pressure of water vapor in the growth atmosphere with CH4. However, as CH4 is a dopant of carbon, a compensating acceptor, its addition may increase electrical resistance. In this study, we further investigated the effect of reducing water vapor partial pressure on polycrystals by combining Ga2O production (reaction of Ga and water vapor: a Ga–H2O system), which can reduce water vapor, with CH4 addition. However, CH4 addition to the Ga–H2O system increased polycrystal generation, possibly owing to the thermal decomposition of excess CH4. The properties of OVPE-GaN with CH4 addition were also evaluated. Although the CH4 addition resulted in high carbon doping, the carbon-doped OVPE-GaN maintained low resistivity. This is because the OVPE method involves three-dimensional growth with growth pits, and the growth pits leave behind low-resistivity high-oxygen-concentration regions. As the resistivity remains low even when CH4 is added in the OVPE method, both polycrystallization suppression and low resistivity can be achieved by selecting an appropriate CH4 flow rate. [ABSTRACT FROM AUTHOR]

Sufian Elfandi,1 Sotaro Ooto,1 Manabu Miyata,1 Naoko Ueda-Arakawa,1 Yousif Subhi,1,2 Kenji Yamashiro,1 Hiroshi Tamura,1 Akio Oishi,1 Masayuki Hata,1 Nagahisa Yoshimura,1 Akitaka Tsujikawa1 1Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Sotaro OotoDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine Email ohoto@kuhp.kyoto-u.ac.jpPurpose: To compare the 12-month efficacy of intravitreous aflibercept (IVA) injection between eyes with pachychoroid neovasculopathy and neovascular age-related macular degeneration (AMD).Methods: Retrospective, comparative case series analysis. Twenty-seven eyes with pachychoroid neovasculopathy and sixty-three eyes with neovascular AMD. All patients received three initial monthly, followed by bimonthly, IVA injections.Results: Twelve months after initial treatment, the mean best-corrected visual acuity (BCVA) had improved both in pachychoroid neovasculopathy (from 0.28 to 0.14 logMAR; P = 0.001) and neovascular AMD (from 0.40 to 0.29 logMAR; P < 0.001). Twelve months after initial treatment, eyes with pachychoroid neovasculopathy exhibited decreased mean central retinal thickness (CRT) and subfoveal choroidal thickness (both, P < 0.001) and presence of polyps (P = 0.039) and improved integrity of external limiting membrane (ELM) (P = 0.008) and ellipsoid zone band (P = 0.001). At the 12-month follow-up, 77% and 68% of eyes with pachychoroid neovasculopathy and neovascular AMD, respectively, exhibited dry macula (P = 0.30). Baseline CRT was correlated with 12-month BCVA in eyes with pachychoroid neovasculopathy (P = 0.02). In eyes with neovascular AMD, CRT (P = 0.005) and presence of intact ELM (P = 0.007) were significant predictors of 12-month BCVA.Conclusion: Periodic IVA injection leads to anatomical and functional improvement in eyes with pachychoroid neovasculopathy and in eyes with neovascular AMD.Keywords: age-related macular degeneration, aflibercept, pachychoroid neovasculopathy, choroidal thickness

Masako Kuroda,1 Yasuhiko Hirami,1–3 Masayuki Hata,4 Michiko Mandai,1–3 Masayo Takahashi,1–3 Yasuo Kurimoto1–3 1Department of Ophthalmology, Kobe City Medical Center General Hospital, 2Department of Ophthalmology, Institute of Biomedical Research and Innovation Hospital, 3Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Kobe, 4Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan Background: The purpose of this study was to observe the characteristic findings of spectral-domain optical coherence tomography (SD-OCT) images in the retinas of patients with retinitis pigmentosa and to evaluate their distribution patterns in the early and advanced stages of the disease. Methods: A total of 184 patients (368 eyes) with retinitis pigmentosa were observed using SD-OCT. We studied the presence or absence of continuous inner/outer segment (IS/OS) lines, presence of thinning of the retinal pigment epithelium-Bruch's membrane complex, and distribution patterns of hyperreflective foci in the inner and outer nuclear layers (INL and ONL). Results: The IS/OS junction had partially disappeared in 275 eyes, which were at the early stage of retinitis pigmentosa (group X), whereas the junction had totally disappeared in 93, which were at the advanced stage of retinitis pigmentosa (group Y). Hyperreflective foci in the INL were observed in a significantly larger proportion of the eyes in group X than in group Y (90% versus 61%, P

Masayuki Hata, Kazuaki Miyamoto, Akio Oishi, Yugo Kimura, Satoko Nakagawa, Takahiro Horii, Nagahisa Yoshimura Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan Background: The retinal nerve fiber layer thickness (RNFLT) in patients with optic disc swelling of different etiologies was compared using scanning laser polarimetry (SLP) and spectral-domain optical coherence tomography (OCT). Methods: Forty-seven patients with optic disc swelling participated in the cross-sectional study. Both GDx SLP (enhanced corneal compensation) and Spectralis spectral-domain OCT measurements of RNFLT were made in 19 eyes with papilledema (PE), ten eyes with optic neuritis (ON), and 18 eyes with nonarteritic anterior ischemic optic neuropathy (NAION) at the neuro-ophthalmology clinic at Kyoto University Hospital. Differences in SLP (SLP-RNFLT) and OCT (OCT-RNFLT) measurements among different etiologies were investigated. Results: No statistical differences in average OCT-RNFLT among PE, ON, and NAION patients were noted. Average SLP-RNFLT in NAION patients was smaller than in PE (P

Anandi V Law, Eric K Gupta, Micah Hata, Karl M Hess, Roger S Klotz, Quang A Le, Emmanuelle Schwartzman, Bik-Wai Bilvick Tai Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA Abstract: Collaborative practice among health professionals is slowly coming of age, given the global focus on efficiency and effectiveness of care to achieve positive patient outcomes and to reduce the economic burden of fragmented care. Collaborative pharmacy practice (CPP) is accordingly evolving within different models including: disease management, medication therapy management, patient centered medical home, and accountable care organizations. Pharmacist roles in these models relate to drug therapy management and include therapy introduction, adjustment, or discontinuation, patient counseling and education, and identification, resolution, and prevention of problems leading to drug interactions and adverse reactions. Most forms of CPP occur with physicians in various settings. Collaborative practice agreements exist in many states in the US and are mentioned in the International Pharmaceutical Federation policy statement. Impetus for CPP comes from health system and economic concerns, as well as from a regulatory push. There are positive examples in community, ambulatory care, and inpatient settings that have well documented protocols, indicators of care, and measurement and reporting of clinical, economic, and patient reported outcomes; however, implementation of the practice is still not widespread. Conceptual and implementation challenges include health professional training, attitudes, confidence and comfort levels, power and communication issues, logistic barriers of time, workload, proximity, resistance to establish and adopt regulations, and importantly, payment models. Some of the attitudinal and perceptual challenges can be mitigated by incorporation of interprofessional concepts and practice in health profession education. Other challenges need to be addressed across health systems, given the inefficiencies and problems that arise from lack of communication and coordination of patient care including medication nonadherence, errors and patient safety, complexity of compounded health problems, and potential liability. The existing evidence needs to be examined to address some challenges and improve infrastructure for CPP. Keywords: collaborative pharmacy practice, collaboration model, interprofessional education, collaborative patient care, coordination of care, continuity of care

Masayuki Hata,1 Kazuaki Miyamoto,1 Ken Ogino,1 Shinji Sumiyoshi,2 Nagahisa Yoshimura11Department of Ophthalmology and Visual Sciences, 2Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, JapanBackground: Here we report three cases of conjunctival lymphoma that were initially unnotified or misdiagnosed as other ocular diseases because of the small tumor size, peripheral tumor location (the tumor was hidden in the fornix), and nonspecific symptoms.Methods: Three patients diagnosed with conjunctivitis or nasolacrimal duct obstruction were referred to our clinic because they were unresponsive to standard medical treatments. Routine anterior segment examination did not reveal any lesions, but further careful examination with a strong eyelid draw revealed minimally elevated tumors in the peripheral fornix under the lid. Excisional biopsies were performed.Results: Histopathologic and immunohistologic examinations indicated the presence of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). All patients underwent additional radiation therapy. There was no evidence of recurrence in any patient during the follow-up period.Conclusion: Detection of conjunctival lymphoma can be challenging. If no apparent lesion is present and the patient has nonspecific symptoms, the inner surface of the eyelid should be carefully examined. Elaborate eyelid eversion, with eyeball movement, should be performed to avoid misdiagnosing or overlooking peripheral conjunctival lymphomas.Keywords: MALT lymphoma, conjunctival lymphoma, misdiagnosis, fornix